Additional speech therapist...

Last week we started taking Ella to see a private speech therapist, as a supplement to the school-based therapy she gets right now. So far she's had two visits, but these have mostly focused on evaluating Ella's existing speech in detail (using parts of a Kaufman Speech Praxis test).

This isn't to say the school system isn't doing a good job, but the school environment and private therapy settings offer different advantages. The school environment offers a lot of other kids her age to model from, as well as a mixture of both group and one-on-one speech therapy. However, neither of us are present at school, and we do not have frequent interactions with her therapists. This means that our at-home efforts are a little unguided and only sync-up with the school once a month or so.

The private therapy, on the other hand, is all one-on-one and there's no peers to learn from. However, one of us attends each session, and her therapist intends to start giving us plans for at-home therapy tactics.

Adding another therapist now also seems very appropriate. Since she got her glasses she's made a lot of progress in the "raw fundamentals" of speech. This seems to us (and her school therapists agree) to be a very good time to increase the intensity of her therapy and catch her up a bit now that she's starting to pick things up faster.

As for her speech progress, we've recently seen several new bits of speech progress emerge:

-she combines "hi" with a name to form a two-word greeting. (Hi Dada)

-she uses a lot more different letter combinations than before in her babbling.

-she's started jargoning where she's stringing together a stream of different syllables, rather than just repeating the same one or two. ("nabooka dooga aeee!" instead of "booka booka booka")

Of course, there's lots of things she's still having trouble with, such as sounds that involve bringing the tip of your tongue up (t, l, etc.), sounds using the teeth (f, v, th, s) and most sound combinations that involve going from an open jaw to a mostly closed one. But that's what we're all working on.

catching the blog up...

Ok, first a little oldish news that I haven't relayed to the blog:

At a meeting with Ella's OT, she suggested that Ella may have depth perception issues, and we might want to take her to a developmental optometrist. We took that as good advice and the results were that Ella is severely farsighted (+7.5 d), and can't focus on things close to her. As a "stepping stone" the optometrist suggested getting glasses at +6.5 see how she does with them, and visit for a follow-up (which is coming up in a week or 2 now).

Now for the rest:

Since getting the glasses, Ella has greatly improved in several areas, particularly in motor ability. The ability to focus on things close to her has given her a better ability to traverse stairs, jump, and the confidence to run around. Her general activity level is also up quite a bit. It has also increased her attention span for hands-on activities etc. We also expect this will have a positive impact on her speech, as she'll be able to see the details of how we move our mouths and tongues while speaking. She still has some motor obstacles to speech (i.e.: she cannot curl her tongue upwards yet), but the glasses at least remove one obstacle.

Of course, we recently had her mid-term IEP meeting with her teachers, where we plan her education goals, therapy levels, etc. Unfortunately, all of the review was written before her glasses arrived, and some of her goals are likely to be rather low now that she can see better. On the upside, we've got another meeting to discuss summer semester soon, and her teacher mentioned we may amend her IEP at that meeting if needed.

brief news bits..

Just a little quickie here:

Ella's been sick for the past week or so with bronchitis. However, she's finishing up a course of antibiotics, and it is clearing out now.

Ella also seems to be working on a speech approximation for "bye bye", although at this point it is little more than "buh buh". On the plus side, she's continuing with the use of ma ma, da da, and og (frog). She also frequently uses a spoken "I" mixed into her signs, and very rarely she says "Hi". All of this is really good news, as it means her spoken vocabulary is growing. In the past we've seen patterns where a new sound replaces an old one.

Ella has also taken to a lot of play activities that are good for balance and strength. Lots of jumping, bouncing, crab walking, etc. She's even starting to work on a broad jump, not just a vertical hop (I think this is her teachers in action, but I have not directly asked them).

Tech-speak device and speech news.

Again, I'm a bit behind in updating the blog, but the holidays always make life a bit busy. So, with that asside, here's a quick update of what's been going on.

First, Ella's school has sent home a Tech/Speak device. This is essentially a board of buttons with pictures on them, and when Ella pushes the buttons, it speaks words. The hope is that it will make her realize that spoken-word can help her communicate with more people, thus encourage her to work on transitioning from signing to speaking.

As for speech, Ella's had a few new words/word aproximations emerge over the holiday. In addition to "da da" and "og" (frog), she's now using "ma ma" (which she had a long time ago, but disappeared for a year), and "ah ah ooh" (uh-oh). What seems most positive to me is she very quickly started using these words appropriately, because she already has the concepts of how to use language down from her signing. This makes me very hopeful that once we can break through the physical co-ordination of her mouth, she'll fall rapidly into speaking.

In any event, we all had a great Thanksgiving, and I hope you all did too.

Oh the many sundry things..

It's been a long time since I've updated how Ella's doing, so here's some quick general bits..

Talking - Ella now occasionally uses a few crudely formed words with purpose. However, she's more inclined to use them as general bables than with any purpose. The most notable exception to this is saying "I" in the middle of signing "may I be excused".

Eating - Ella is doing really good with self feeding, and can now spoon her own cereal out of a bowl. She'll also pick up and bite chunks out of food that she strongly likes, such as fries and nuggets, although less favored foods still need to be cut up for her.

Motor - Ella's gotten pretty good at jumping (over, and over and over again) in-place in little short hops, and getting on and off her tricycle. Her motor is generally doing pretty good, although she is a little bit behind her peers in more ambitious climbing and balance adventures.

School - Ella went back school this past Thursday. She's now in a preschool class instead of a toddler class (higher age group) and is now in a regular early-childhood special ed program, not a MINC (higher development level). The later means that she's not with any of her former classmates, which is unfortunate, but she's doing fine with it.

Potty - Well, we're still working on this one. Ella does pretty well at using the potty, but her enthusiasm for wearing underwear instead of diapers varies wildly (often very resistant to wearing one or the other, usually wanting the exact opposite of what works for the planned day)

Anyway, hope you're all well, I just wanted to get a quick update of how things are going.

moving up from the MINC program...

Originally it was a judgment call between putting Ella into a MINC-T (multiple intense needs class for toddlers), or putting her into the normal special ed toddler class. Ultimately, the MINC was chosen to afford Ella extra therapy time, and a smaller class for her first school.

Recently, the paperwork was done for Ella's school starting this fall. For age reasons, she's going to be moving from toddler class to preschool class. Given how well she's been doing in the classroom, and how well she socializes with other children, the staff recommended that Ella move up from the MINC program to the normal special ed preschool. We've decided to go ahead and do that.

This does mean Ella's one-on-one time with school therapists will be going down, but it also means the class activities will be more challenging for Ella, and provide her with better opportunities to advance on her own or from her peers. With her current progress in motor and social areas, I think this is very important. She's also been babbling back-and-forth with her peers, and this class is also likely to have more students in it for Ella to "talk" to.

This isn't terribly fresh news, as we've known about it for a while, but the paperwork was finalized this past week, so I figured it's past due to put it up on the blog.

Go Ella Go!

Back to school, and sign list..

Well, Ella's back to school following spring break, and she seems quite happy to be back at school. Today she even showed us a new sign related to school. We were at dinner and she signed "learn", and when asked about it she signed "learn - school". I guess our semi-recent addition of signing time vol 13 has a lot to do with that.

In general Ella continues to become more and more sociable, and communicative, and she continues to babble a lot and will repeatedly make specific babble sounds when prompted (Da, Hu, Gu, tooka, dooga). That's good because it demonstrates she has the idea of making specific sounds for a specific purpose. While she does a few other babbles (bu, and rarely pu), the odds of her echoing them back at your request is pretty low (15%?)

I've also converted my list of Ella's signs to a google doc, and I've added a link to it in the links section on the right, or you can just jump from here. I figure that will be useful for anyone interacting with Ella and wanting to know which signs she knows. It also has notes about some of her modifications to various signs.

School..

Bad blogger, no biscuit!

I mentioned back earlier that Ella would be starting school on the 17th, and it's almost two weeks after that and I've not blogged about it. Tsk. Tsk. Tsk. So, there's no a LOT to blog about, and I apologize in advance if this post is a bit long and desne.

In any event, Ella is taking well to school. During the first week there was definitely some crying, particularly while being dropped off, but she has now acclimated to school as a part of her regular routine. Of course, she's off 7 school days in a row for spring break starting Friday, so we'll see how she does after a longer break than just a weekend.

Ella's class consists of 8 children, a few of whom are typically developing and the rest are other children with delays from a variety of different situations. Being a toddler class, the classes are mostly learning play oriented. The staff consists of a teacher, a few teaching assistants, and 3 therapists. Generally speaking, the therapists rotate in and out of the class, while the rest of the staff is present more-or-less every day. The children spend most of their time in group activities, and some of their time one-on-one with a therapist.

As for communicating home, there are a couple of things that are used to keep us informed. Every day, there's a binder that she takes to school with her, and brings home when she's done. These binders contain a series of laminated pages with pictures of the other children, staff, foods and toys. Near the end of the day, one of the staff places stickers on the pictures of who and what she played with, and what she snacked on at snack time. The binder also allows us to pass notes and references to the school staff, such as the list of Ella's signs we've placed in there.

In addition, Ella's teacher comes to our house once a week. We've only had one of these sessions so far, but these visits mostly focus on passing information back and forth. Her teacher tells us what she's been doing in class, and we tell her about some of her recent developments at home. Of course, Ella participates in the meetings to. This gives her teacher a chance to see some of the things Ella does in a home environment, where she's more comfortable, that she won't do in school.

One thing I have noticed is that she's been *really* excited about babbling lately. Obviously I can't prove the extra social interaction is causing it, but it's certainly not hurting. Also, Mental Mother tells me she's been coming home rather tired and napping quite hard most days. That's also a good sign, as it means the class is successfully stimulating her.

Whew. That's quite a dense post. I'll (hopefully) post more in the next few days.